Gary J Padovani MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G44340 Issued in CA

Legal business name

GARY J PADOVANI MD

Practice address

1421 Oakdale Road
Modesto, CA 95355

Phone

(209) 572-2700

NPI assigned

Nov 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary J Padovani, MD

Title

President

Phone

(209) 529-9603

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861564866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 COFFEE ROAD",
            "address_2": "C3",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-529-9603",
            "fax_number": "209-529-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 OAKDALE ROAD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-572-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY J PADOVANI MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PADOVANI",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-529-9603",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G44340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G443400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.